[Reconstruction methods to achieve optimal postoperative bowel function following low anterior resection for rectal cancer].
After low anterior resection for rectal cancer, approximately 50% of patients experience defecatory malfunction such as multiple evacuations, urgency, and soiling. Since the neorectum is constructed with the remaining colonic segment, it can only substitute for the rectum to a limited extent. A straight anastomosis is most frequently used when the rectal remnant is sufficient, such as in high anterior resection. When the height of anastomosis is close to the anal sphincter, a J-pouch, a side-to-end, or a transverse coloplasty pouch are constructed to achieve better postoperative bowel function. The advantage of J-pouch reconstruction is not only the increased volume but also may be decreased motility when compared with straight reconstruction. In terms of postoperative function, the side-to-end and transverse coloplasty pouch have both been reported to exhibit similar functional results to J-pouch reconstruction. To obtain optimal functional results, pouch reconstruction should be considered, especially when the height of anastomosis is at the levator plane.
Koda
Keiji
K
Department of Surgery, Teikyo University Chiba Medical Center, Japan.
Yasuda
Hideki
H
Suzuki
Masato
M
Yamazaki
Masato
M
Tezuka
Tohru
T
Kosugi
Chihiro
C
Higuchi
Ryota
R
Sugimoto
Maki
M
Hirano
Atsushi
A
Uemura
Shuichiro
S
Tsuchiya
Hironori
H
D039021:Colonic Pouches; D003672:Defecation / Q000502:physiology; D006801:Humans; D012004:Rectal Neoplasms / Q000601:surgery*